A number of medical procedures involve the irrigation of a body cavity. For example, it is necessary to irrigate the urinary bladder during many endoscopic urologic procedures to flush out (and in some cases collect) blood clots, pieces of tissue, and the like. The general approach to accomplish this is to introduce a sterile saline solution or water into the bladder and then withdraw the fluid which has mixed and suspended material to be removed. This process needs to be repeated until the withdrawn fluid becomes clear and satisfactorily free of particulate material.
Presently, the most common device used for bladder irrigation is the Ellik evacuator. The Ellik evacuator consists of a clear hourglass-shaped bowl with rubber bulb and nozzle fitted to the upper bowl for circulating solution through the urethra and the bladder. The bulb is opaque and oriented at a right angle to the axis of the hourglass. Because of this, one problem with the Ellik evacuator-is the difficulty in fluid filling and air purging. Tissue found in the return flow of solution ideally is collected in the lower chamber. Tissue collects there due to the effects of gravity. Thus, another limitation of the Ellik evacuator is that the entrained tissue must settle by gravity into the lower chamber. As a result, only the particulate and tissue of a specific gravity greater than that of the sterile solution will settle into the lower chamber. The particulate in suspension in the upper chamber tends to be reintroduced into the bladder when the bulb is again compressed. Also, tissue or particulate matter is often sucked into the bulb regardless of specific gravity and because of the opacity of the bulb, tissue caught there cannot be visualized and may become lost. In order to prevent the recirculation of contaminated solution created by the initial irrigation with the Ellik evacuator, the surgeon must empty and refill the Ellik repeatedly until the final irrigation remains clear. In addition to this repetitive exercise, each time the Ellik evacuator is emptied and refilled, the tissue that has accumulated in the irrigant must be filtered and removed from the basin by hand at the conclusion of the irrigation. During this step, tissue is occasionally lost on the table or floor and there are significant blood and tissue exposure risks to operating room personnel. A final problem with the Ellik is that the rubber bulb is plugged like a stopper into a smooth glass tubular port. Since the neck of the bulb is smooth and cylindrical, there is only friction without mechanical advantage to hold them together. Consequently, the bulb may easily detach from the glass container inadvertently during handling with the result that the glass container can crash to the floor and shatter.
A number of attempts have been made to improve upon the Ellik evacuator. These efforts include the devices described in U.S. Pat. Nos. 3,892,226; 4,282,873; 4,729,764, 4,801,292; 5,338,294; and 5,421,824. In addition to their own unique limitations, all of the devices taught by these patents fail to duplicate the ideal degree and velocity of fluid turbulence that is generated with the Ellik evacuator. Furthermore, none of these devices have a readily transferable tissue collecting mechanism. For example, in U.S. Pat. No. 5,421,824, a squeezable portion of the container forces fluid from the container into the body cavity and by releasing the compressional forces allows the squeezable portion to expand and withdraw the fluid. Unfortunately, the fluid turbulence generated by this squeezable portion, and specifically the negative pressure generated when releasing the compressional forces, is inadequate and does not match those of the Ellik evacuator. Moreover, there is often leakage of fluid at the juncture of the container and its cap. Additionally, while this patent prevents particulate tissue from reentering the body cavity, it does not have a readily transferable tissue collecting mechanism and thus suffers from the same limitation as the Ellik evacuator in that the tissue collected by the device must be filtered and removed from the basin by hand at the conclusion of the irrigation. During this step, tissue is occasionally lost on the table and floor and there is significant blood and tissue exposure risk to operating room personnel in this maneuver.
Thus, there remains a need for an improved irrigation and tissue evacuation and collection system.